43D1036504 CLIA NUMBER - PHILIP CLINIC

Laboratory Demographics

  • CLIA Code: 43D1036504
  • Facility Name: PHILIP CLINIC
  • Facility Address: 503 WEST PINE POST OFFICE BOX 790
    PHILIP, SD
    ZIP 57567
  • Facility Phone: 605 859-2566
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: LARISSA WISHARD
  • NPI Number: 1609453422
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 43D1036504
LAB Type Rural Health Clinic
Facility Name PHILIP CLINIC
Street 503 WEST PINE POST OFFICE BOX 790
City PHILIP
State SD
ZIP 57567
Phone 605 859-2566
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2025
Certificate Expiration Date 2/3/2027
Facility Type Rural Health Clinic
Lab Director LARISSA WISHARD

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This page was last updated on: 9/29/2025